Delivering MACRA Care Under the Final Rule- Implementation Considerations and Implications

      
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Delivering MACRA Care Under the Final Rule- Implementation Considerations and Implications 
 
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Overview
On October 14, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published the final rule implementing Medicare physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). MACRA repeals the Medicare Sustainable Growth Rate methodology for updates to the Medicare Physician Fee Schedule (“MPFS”) and replaces it with a new approach to payment called the Quality Payment Program available for eligible providers under the MPFS through two avenues: Advanced Alternative Payment Models (“Advanced APMs”) and the Merit-based Incentive Payment System (“MIPS”). Under the final rule, various changes including some simplification and streamlining of certain processes were made to the proposed rule that had been released in April, based in part on over 4,000 comments received and feedback from a number of the 100,000-plus physicians and other stakeholders attending CMS outreach sessions.

Along these lines, the final rule sets forth special policies for the first year of the Quality Payment Program, referred to as the “transition year” which corresponds to the first performance period of the program, calendar year 2017, and the first payment year, calendar year 2019. CMS envisions that it will take a few years to reach a steady state in the program, and anticipates a ramp-up process and gradual transition with less financial risk for clinicians in at least the first two years. CMS states that their "hope is for the program to evolve to the point where all the clinical activities captured in MIPS across the four performance categories reflect the single, unified goal of quality improvement."

CMS notes that the final rule allows for participation in certain APMs that provide added incentives to deliver high-quality and cost efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. The final rule also establishes MIPS, which will consolidate components of three existing programs, the Physician Quality Reporting System, the Physician Value-based Payment Modifier, and the Medicare Electronic Health Record (“EHR”) Incentive Program for Eligible Professionals, and will continue the focus on quality, cost, and use of certified EHR technology (“CEHRT”) in a unified program.

Now that the final rule is published, stakeholders should finalize positioning themselves for the MACRA transition period and beyond. During this session, an overview will be presented of the provisions and changes involved with the final rule, including discussion of the implications of the transition period and revisions intended to streamline and simplify processes. Implementation timelines will be discussed, and how changes in the final rule impact the timeline. Implications of the MIPS scoring system will be addressed, including how to better understand the composite scoring mechanism, and how performance is defined under each of the four performance categories under MIPS. The presentation also will address additional details of the final rule provisions, along with implications and considerations for ongoing preparation and implementation steps.

Please join us Friday, November 18th, 2016 at 1 PM Eastern as Epstein Becker Green's Mark Lutes and Lesley Yeung and EBG Advisors' Bob Atlas cover a range of MACRA issues and considerations under the final rule in the HealthcareWebSummit event: Delivering MACRA Care Under the Final Rule- Implementation Considerations and Implications.
Learning Objectives

After attending this webinar, attendees will be able to:

  1. Identify the specific changes from the proposed rule included in the final rule for MACRA
  2. Ascertain the scope of the proposed rule that did not change under the final rule
  3. Consider any strategic adjustments now that the final rule provisions have been published 
  4. Ascertain MACRA APM and MIPS components, provisions and timing relating to the final rule
  5. Understand key concepts and specifications for the MIPS composite scoring mechanism
  6. Ascertain detailed considerations relating to the MIPS performance categories
  7. Explore various implications relating to ongoing MACRA preparation and implementation
  8. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group.
Who Should Attend

Interested attendees would include:

  • C-Suite Executives
  • Healthcare Innovation, Transformation and Reform Executives
  • Healthcare Payment Transformation Executives
  • Legal, Regulatory and Policy Executives and Staff
  • Provider Performance Analytics Executives
  • Provider Relations and Contracting Executives and Staff
  • Provider Network Operations Executives and Staff
  • Finance Executives and Staff
  • Managed Care Executives and Staff
  • Planning and Strategic Executives and Staff
  • Business Intelligence Staff
  • Other Interested Parties

Attendees would represent organizations including:

  • Medical Groups
  • Hospitals and Health Systems
  • Accountable Care Organizations
  • Provider Networks
  • Other Healthcare Providers
  • Health Plans
  • Government
  • Pharmaceutical Organizations
  • Solutions Providers
  • Associations, Institutes and Research Organizations
  • Media
  • Other Interested Organizations
Registration
Delivering MACRA Care Under the Final Rule- Implementation Considerations and Implications
 
  Individual Registration Fee: $195. Post-event materials, with video syncing slides and recorded audio, plus presentation pdf file: $45 for attendees; $240 for non-attendees after the event. Register online or download the event brochure.
 
 
 
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Faculty
 
Mark E. Lutes

Mark E. Lutes
Chair, Board of Directors; Member of the Firm
Epstein Becker Green

  Mark E. Lutes is a Member of the Firm in the Health Care and Life Sciences practice of Epstein Becker Green and the Chair of the firm's Board of Directors. Based in Washington, DC, he has practiced with the firm for nearly three decades. Prior to that, he was a legislative adviser to the Federal Trade Commission. He also offers strategic counsel in health policy and on reimbursement strategy through the firm's affiliates EBG Advisors, Inc., and National Health Advisors, LLC.

Mr. Lutes is a leader in the firm's representation of private equity and financial services firms with health care companies in their portfolios. He routinely deploys multidisciplinary teams of attorneys, reimbursement specialists, engineers, and scientists to assess the reimbursement, FDA and other domestic and international regulatory approvals, fraud and abuse compliance, CMS and legislative landscapes and other issues impacting proposed client investments in health care companies. Mr. Lutes combines experience with the corporate aspects of transactions with his deep experience in health care compliance issues to provide clients with practical advice in the negotiation of warranty and indemnification issues and in assessing risk factors in health and life science deals. He has advised on the largest transactions in the health care market including services, pharmaceutical and device companies.

Mr. Lutes is also an experienced antitrust counselor to health care companies contemplating mergers or acquisitions and has facilitated the antitrust clearance of numerous significant hospital mergers. He has managed the defense of high profile healthcare antitrust actions by the FTC.

Mr. Lutes has a deep understanding of managed care markets and regulation. He is consulted by a variety of providers and payors in structuring innovative payment arrangements. Additionally, he counsels on hospital and physician ventures and compliance issues and in the area of information privacy and security. Mr. Lutes has developed privacy and security audit tools which support client compliance needs.

He has been selected for inclusion in Washington, DC Super Lawyers (2007 to 2010, 2013, 2014) and honored by Nightingales as a leading health care antitrust lawyer. He is ranked among the "Leaders in Their Field" by Chambers USA (2010 to 2014).

Mr. Lutes is active in his parish and serves as Chair of the Advisory Board of the Spanish Catholic Center, a social and health services nonprofit. He also serves on the President's Council of Catholic Charities, Archdiocese of Washington, DC, which honored him with The Caritas Award, its highest recognition of volunteers. Mr. Lutes also has over a decade of service in leadership in the Boy Scouts of America organization.

 
Lesley R. Yeung

Lesley R. Yeung
Associate
Epstein Becker Green

 

Lesley R. Yeung is an Associate in the Health Care and Life Sciences practice in the firm's Washington, DC, office. Ms. Yeung has been selected to the Washington DC Rising Stars list (2014 to 2016) in the area of Health Care.

Ms. Yeung: Advises health care providers and health-related companies, financial institutions and investors of industry trends and policy developments; Advises hospitals, health systems and other health-related companies on legal and regulatory matters arising under Medicare, Medicaid and other third-party reimbursement programs; Advises clients regarding federal and state health care regulatory issues, including licensing and reimbursement matters associated with change of ownership; and Assists health care providers with government investigations relating to health care fraud and abuse arising under anti-kickback laws, the Stark Law and the False Claims Act.

Ms. Yeung recently served as a law clerk at a large nonprofit membership organization, where she supported litigation efforts related to the provision of long-term care services under the Americans with Disabilities Act. Prior to attending law school, Ms. Yeung was a health insurance specialist at the Centers for Medicare & Medicaid Services. She also previously worked as a program analyst at the Department of Health and Human Services and as a presidential management fellow at the National Institutes of Health.

Ms. Yeung received her J.D. from The George Washington University Law School; her M.P.A. from New York University, Robert F. Wagner Graduate School of Public Service and her B.A. from Boston University. She is a member of the American Bar Association and New York State Bar Association.


 
Bob Atlas

Robert F. Atlas
President and Strategic Advisor
EBG Advisors

 

Bob Atlas is President of EBG Advisors, a health care consultancy affiliated with the law firm of Epstein Becker Green.

Mr. Atlas has nearly four decades of experience as an advisor to senior leaders and governing authorities in the health care industry and the public sector. He consults on strategy, policy analysis, program development, and performance improvement for health care providers, payers, policymakers, product makers, investors, and other stakeholders. He is well regarded for his expertise in managed care and accountable care, health services management, health care finance, and the public insurance programs, Medicaid and Medicare.

Of late, Mr. Atlas has been engaged in governmental health financing innovations. He led a team implementing national health insurance in a Caribbean island nation and is currently engaged with two states’ Medicaid agencies designing coordinated care solutions that feature patient-centered medical homes spanning primary care through long-term services and supports. He is also working with providers, health plans and life sciences companies on deploying value-driven care concepts in sustainable programs.

In the years before joining EBG Advisors, Mr. Atlas was principal executive of three nationally prominent health care consulting firms. Previously, after earning an M.B.A. in Health Administration and Finance from The University of Chicago Booth School of Business, he served as a commissioned officer in the U.S. Public Health Service. He worked in Medicare’s quality-of-care office and in the agency responsible for promoting the growth of health maintenance organizations.

 
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